Meta-analysis Of The Efficacy Of Drug Therapy And Mitraclip In Patients With Heart Failure And Functional Mitral Regurgitation

Objective:The use of MitraClip system for percutaneous mitral valve repair for mitral regurgitation has become an emerging minimally invasive treatment.For more than ten years,MitraClip has been used in Europe and the United States to treat primary mitral regurgitation,but for the left heart.The efficacy of MitraClip can be applied to patients with dysfunctional secondary MR,and the guidelines have been unfounded.The purpose of this meta-analysis was to compare the efficacy and prognosis of patients with functional MR in the treatment of MitraClip system and drug alone.Methods:A comprehensive literature search was conducted on PubMed,Embase,The Cochrane Library,Medline,Embase,Ovid and Cochrane,CNKI,and Wanfang databases to obtain randomized controlled trials and observational studies on drug-treated MR and MitraClip for functional MR..Efficacy events included all-cause death and cardiogenic admission during follow-up.At the same time,the manual search and inclusion of the research references,screening,data extraction and quality evaluation according to the inclusion and exclusion criteria,using RevMan5.3software for analysis,the summary effect by calculating the odds ratio(OR)and 95%confidence interval(CI)indicates that if P<0.05 is combined after statistical analysis,the difference is statistically significant.Results:A total of 6 cohorts,2 RCT studies,and a total of 2005 subjects were included,with a follow-up period of 1-2 years.Meta-analysis results show that MitraClip combined with drug therapy can significantly reduce the risk of all-cause mortality in patients compared with drug therapy alone(OR: 0.68;95% CI: 0.55-0.80;P<0.00001),which can reduce the hospital admission rate(OR: 0.72;95% CI:0.60-0.87;P=0.0005),can reduce the risk of death from heart disease(OR: 0.65;95%CI: 0.54-0.78;P<0.00001).Conclusion:Compared with drug therapy alone,MitraClip systemic treatment of functional MR patients had a significantly lower risk of all-cause mortality;compared with conservative treatment,MitraClip combined with drug therapy had a significantly reduced rate of cardiovascular readmission and heart disease mortality.